Abstract
Background In order to improve the safety of drugs in pregnancy and
lactation, it is imperative that data on clinical practice be collected and
validated.
Methods Data on routinely used medications were requested from 9 Swiss
perinatal centres (5 university hospitals for obstetrics and 4 non-university
centres). Furthermore, recommendations and guidelines from scientific societies
for the fields of application were sought.
Results Part II (lactation): For the lactation period, 48 different active
substances were each identified by at least 4 centres. The active constituents
most frequently cited by the centres were i. v. iron, lorazepam,
nifedipine and paracetamol. Only a few guidelines were found that explicitly
refer to the breastfeeding period. Therefore, fewer recommendations for use
during lactation could be found compared with during pregnancy.
Conclusion As with during pregnancy, the same active ingredients are
consistently used in Swiss perinatal centres for many different indications
during lactation. Most of these active ingredients are labelled with a warning
or are even considered to be contraindicated; their use is therefore mainly
off-label. Official authorisation for frequently or consistently used active
substances is urgently needed. With this study, a first important step towards
national harmonisation has been taken.
Key words
off-label use - pregnancy - lactation - drugs - perinatal centre - recommendations
